望诊在郁病诊疗中的独特应用

Unique application of the inspection methods in the diagnosis and treatment of stagnation disease

郁病为情志不舒引起气机郁滞、脏腑功能失调而导致的疾病,临床表现复杂。因患者存在精神情志的紊乱,问诊未必能满足临床诊断辨证需求。古代医家尤其重视对郁病患者的望诊,进而判断病性与病位等,包括:望神断阴阳之偏,可直接判断神志失常及其证候;望形判虚实之状,即判别患者禀赋强弱、体质虚实,郁病患者多先天禀赋不足、真气虚弱;望面定五脏病位,即通过对于情志病患者面部整体或局部状态、色泽的观察,获知其身体的内在情况;望舌辨别证候,通过观察情志病患者舌象特征判断寒热虚实。

Yubing(stagnation disease) is arising from emotional distress leading to stagnation of qi and dysfunction of the zangfu organs,presents with complex clinical manifestations.Due to disturbances in mental and emotional states,clinical diagnosis and syndrome differentiation may not be adequately addressed through inquiry alone.Ancient physicians placed particular emphasis on the inspection,one of the four examinations in TCM,of patients with depression syndrome to determine the nature and location of the disease.This included:observing the spirit to discern deviations in yin or yang,directly assessing mental abnormalities and their associated syndromes;evaluating physique to determine states of deficiency and excess,reflecting the patient's inherent constitution and tendencies towards deficiency and excess.Patients with stagnation disease often exhibit innate deficiencies and weakened vital qi.Facial observation is employed to pinpoint organ pathology,deducing the internal condition of the body through scrutiny of facial complexion and features.Additionally,tongue inspection aids in syndrome differentiation,whereby the characteristics of the tongue in patients with emotional disorders provide insights into deficiencies,excesses,cold,and heat.